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Individual

MACY MARIE PELLETIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
306 RODMAN RD, AUBURN, ME 04210-3830
(207) 249-6901
Mailing address
201 HUSSON AVE APT U9, BANGOR, ME 04401-3242
(207) 249-6901

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC6163
ME
101YM0800X
Mental Health Counselor
XL4906
ME

Other

Enumeration date
07/20/2017
Last updated
12/03/2021
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